Intramesenteric abscess caused by non-typhoidal Salmonella

Abstract

Nontyphoidal Salmonella (NTS) is a common cause of gastroenteritis in humans and animals, but intra-abdominal abscesses or organ space surgical site infection (SSI) secondary to this organism has been rarely reported, making diagnosis and management difficult. Our case of intra-mesenteric abscess caused by NTS species is the only case reported in the literature. Immunocompromising conditions such as diabetes and human immunodeficiency virus (HIV) are important risk factors for invasive nontyphoidal Salmonella. Most patients are treated initially with intravenous antibiotics. Treatment often requires operative drainage by laparoscopy or laparotomy alone, although percutaneous drainage has been performed more frequently in recent years. Early clinical signs and radiographic features of intra-abdominal abscess may be diagnostically challenging. It is important for clinicians to have high index of suspicion based on history and symptomatology as prompt treatment is essential to prevent further morbidity and mortality.

Keywords: Abscess; Intraabdominal infection; Salmonella; Surgical drainage.

Fig. 1

Initial CT abdomen/pelvis. Red arrow indicates an ill-defined 5–6 cm focal fluid collection with surrounding inflammation in the right mid abdomen center around what appears to be a ruptured aneurysm or pseudoaneurysm.

Fig. 2

Repeat CT abdomen/pelvis on hospital day 9. Red arrow indicates a large 8.4 cm complex collection with surrounding mesenteric edema in the right lower quadrant is contiguous with the cecum, ascending colon, and terminal ileum.